The assessment of hemineglect syndrome with cancellation tasks: a comparison between the Bells test and the Apples test

Neurol Sci. 2017 Dec;38(12):2171-2176. doi: 10.1007/s10072-017-3139-7. Epub 2017 Oct 4.

Abstract

Unilateral spatial neglect (USN) is a frequent consequence of acquired brain injury, especially following right hemisphere damage. Traditionally, unilateral spatial neglect is assessed with cancellation tests such as the Bells test. Recently, a new cancellation test, the Apples test, has been proposed. The present study aims at comparing the accuracy of these two tests in detecting hemispatial neglect, on a sample of 56 right hemisphere stroke patients with a diagnosis of USN. In order to evaluate the agreement between the Apples and Bells tests, Cohen's kappa and McNemar's test were used to assess differences between the two methods of evaluation. Poor agreement and statistically significant differences emerged between the Apples and Bells tests. Overall, the Apples test was significantly more sensitive than the Bells test in detecting USN. Based on these results, the use of the Apples test for peripersonal neglect assessment is therefore highly recommended.

Keywords: Apples test; Bells test; Neglect; Rehabilitation; Stroke.

Publication types

  • Comparative Study
  • Multicenter Study

MeSH terms

  • Acute Disease
  • Adult
  • Aged
  • Aged, 80 and over
  • Brain Ischemia / complications
  • Brain Ischemia / diagnosis
  • Brain Ischemia / psychology
  • Cerebral Hemorrhage / complications
  • Cerebral Hemorrhage / diagnosis
  • Cerebral Hemorrhage / psychology
  • Chronic Disease
  • Female
  • Functional Laterality
  • Humans
  • Male
  • Middle Aged
  • Neuropsychological Tests*
  • Perceptual Disorders / diagnosis*
  • Perceptual Disorders / etiology
  • Retrospective Studies
  • Stroke / complications
  • Stroke / diagnosis
  • Stroke / psychology
  • Stroke Rehabilitation / methods